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Michigan Application for Agency Approval as a Rehabilitation Facility (fill-in form)

State:
Michigan
Control #:
MI-WC-502
Format:
PDF
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Description

Application for Agency Approval as a Rehabilitation Facility (fill-in form) The Michigan Application for Agency Approval as a Rehabilitation Facility (fill-in form) is used by organizations seeking approval from the state to operate a rehabilitation facility. This form provides information about the organization, its personnel, its services and its physical plant to the Michigan Department of Licensing and Regulatory Affairs (LARA). The form is used to determine if the organization meets the standards of care and safety required for approval. There are two types of Michigan Application for Agency Approval as a Rehabilitation Facility (fill-in form): * Adult Day Care Facility * Adult Foster Care Facility The fill-in form includes questions about the organization's mission statement, services offered, staff qualifications, physical plant requirements, and financial information. The facility must also provide information about its policies and procedures, emergency plans, and liability insurance. Once the form is submitted, the applicant will be contacted for an onsite visit. After the onsite visit, the applicant may be granted approval or denied based on the findings.

The Michigan Application for Agency Approval as a Rehabilitation Facility (fill-in form) is used by organizations seeking approval from the state to operate a rehabilitation facility. This form provides information about the organization, its personnel, its services and its physical plant to the Michigan Department of Licensing and Regulatory Affairs (LARA). The form is used to determine if the organization meets the standards of care and safety required for approval. There are two types of Michigan Application for Agency Approval as a Rehabilitation Facility (fill-in form): * Adult Day Care Facility * Adult Foster Care Facility The fill-in form includes questions about the organization's mission statement, services offered, staff qualifications, physical plant requirements, and financial information. The facility must also provide information about its policies and procedures, emergency plans, and liability insurance. Once the form is submitted, the applicant will be contacted for an onsite visit. After the onsite visit, the applicant may be granted approval or denied based on the findings.

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Michigan Application for Agency Approval as a Rehabilitation Facility (fill-in form)